Abstract: Objective To investigate the causes of graft loss in kidney transplant recipients. Methods We retrospectively analyzed the clinical data of 135 recipients with graft loss after renal transplantation in the Eighth Medical Center of Chinese PLA General Hospital from January 1, 2002 to January 1, 2022. Results A total of 135 kidney transplant recipients experienced graft failure. The causes of graft loss included graft rejection (70 cases, 51.8%), death of the recipients with functional graft (37 cases, 27.4%), surgical complications (12 cases, 8.9%), drug toxicity (4 cases, 3.0%), carbapenem-resistant Klebsiella pneumoniae infection (4 cases, 3.0% ), polyoma BK virus-related nephropathy (3 cases, 2.2% ), primary nonfunctioning kidney (2 cases,1.5% ), recurrence of primary disease (2 cases, 1.5% ), and prerenal acute renal failure (1 case, 0.7% ) . Conclusion The main cause of graft loss after renal transplantation is graft rejection, and the secondary cause is death of the recipient with functional graft, and other reasons can be rare.

Key words: kidney transplantation; allograft loss; graft rejection; kidney recipients with functional graft